Personal Information Request FormPlease enable JavaScript in your browser to complete this form.Name *FirstLastEmail Address Previously Submitted to Us *You are submitting this request as *The person, or the parent / guardian of the person, whose name appears above.An agent authorized by the consumer to make this request on their behalf.Under the rights of which law are you making this request? *GDPRCCPAOtherI am submitting a request to ___________ *Confirm that my personal information is being processedAccess my personal informationEdit / correct my personal informationHave my personal information deletedRestrict the processing of my personal informationAsk a question about PrivacyWorks’ privacy policyWithdraw my consent to the processing of my personal informationDeny PrivacyWorks the right to use my personal information for purposes of direct marketing, including profilingOther (please specify in the comment box below)Please leave details regarding your action request or question.I confirm that *Under penalty of perjury, I declare all the above information to be true and accurate.I understand that the deletion or restriction of my personal data is irreversible and may result in the termination of services with PrivacyWorksI understand that I will be required to validate my request by email, and I may be contacted in order to complete the request.Submit
